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Have peyronie's disease of the penis. Should I go for nesbit surgery?

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Practicing since : 2003
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I have a banana like curve to the left side (its less than 30 degree i believe) and base is narrow with comparison to top part of the penis. For past 2 months sometimes i feel mild pain in top portion of my penis while its erect. I consulted a urologist, Dr is suggesting Nesbit surgery.
My concern is the risks involve in the surgery and I would prefer non surgical option.
I'm getting married next year.
Please suggest?
Posted Tue, 4 Dec 2012 in Penis Problems
Answered by Dr. Jonas Sundarakumar 4 hours later
Hello and welcome to Healthcare Magic. Thanks for your query.

It appears that your are suffering from a condition called Peyronie's disease of the penis. This condition causes abnormal curvature of thepenis and can result in pain or discomfort during erection. It is caused due to the development of scar tissue or 'plaques' in the spongy tissue of the penis.

Treatment is advised when there are cosmetic concerns due to the abnormal curvature or pain or if it affects sexual performance. Treatment can either be with medical or surgical methods. The commonest and simplest operation is a procedure called the Nesbit’s operation. This involves reducing the length of the normal side of the penis to straighten it. Obviously any operation on the penis has some risk, and as in any operation infection and bleeding can rarely occur. If treated, this is unlikely to have any long term problems, but in rare cases long term damage may lead to impotence. After a Nesbit’s procedure the penis will be one to three centimetres shorter than originally. In some cases the Peyronie’s disease may recur, leading to further bending in the penis: this is why surgery should not be undertaken until the problem has stabilised. Very rarely, particularly if the penis is bent downwards, the nerve supply to the head of the penis may be damaged, leading to numbness. So, there are certain risks involved with this surgery.
Wish you all the best.

Regarding the non-surgical options, firstly, in a small percentage of people, the symptoms can improve on its own after some time. This is why usually doctors advise a waiting period of 2 years after the appearance of symptoms, before deciding on surgery. There are also other medical treatment methods, which have varying success rates.
- Penile injections using special medication like Verpamil, Interferon, collagenase
(which can breakdown the scar tissue and improve the symptoms)
- Other techniques include radiation therapy, using intense sound waves to break up scar tissue (shock wave therapy) and devices to stretch the penis (penile traction therapy)
- Certain oral medication such as Vitamin E have also been claimed to inhibit scar formation and hence improve symptoms.

I would advise you to discuss the benefits and risks of surgery in detail with your Urologist and then take an informed decision.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist & Sexologist
Above answer was peer-reviewed by
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